Provider Demographics
NPI:1316299720
Name:MUSKA, KOREE ROSE (RDN)
Entity type:Individual
Prefix:MRS
First Name:KOREE
Middle Name:ROSE
Last Name:MUSKA
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MS
Other - First Name:KOREE
Other - Middle Name:ROSE
Other - Last Name:FREDETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1100 S. VAN DYKE RD
Mailing Address - Street 2:
Mailing Address - City:BAD AXE
Mailing Address - State:MI
Mailing Address - Zip Code:48413
Mailing Address - Country:US
Mailing Address - Phone:989-269-1572
Mailing Address - Fax:989-269-5206
Practice Address - Street 1:1100 S. VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:BAD AXE
Practice Address - State:MI
Practice Address - Zip Code:48413
Practice Address - Country:US
Practice Address - Phone:989-269-1572
Practice Address - Fax:989-269-5206
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered